Physician Shadowing Application

- MARCH 6, 2021
3D Mammograms Increases Chance for Early Detection
When cancer is detected and diagnosed while still in the early stages, there is a much higher chance of better outcomes with treatment. Many families in Eastern Kentucky experience cancer in one way or another, and Pikeville Medical Center (PMC) is prepared to address their needs. PMC utilizes advanced equipment and technology to increase the
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- JULY 7, 2020
Physicians Take Cancer Care to the Next Level
The Lawson Cancer Center (LCC) offers the region leading-edge technology and a specially trained staff. PMC provides full-service, state-of-the-art cancer treatment and follow-up care, and is among a select few accredited cancer centers in KY that has received commendation by the Commission on Cancer. PMC’s prestigious group of board-certified cancer doctors are dedicated to providing
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- JULY 7, 2020
PMC Offering Clinical Trials for Cancer Patients
Pikeville Medical Center (PMC) was approved to offer cancer patients clinical trials for treatment. Clinical trials are research studies that involve patients. Participation in the trials is not mandatory and patients who meet the criteria are given a choice if they want to participate. PMC began trials to treat numerous types of cancer, including breast
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- OCTOBER 3, 2019
Outreach Programs Help Patient Learn to Live with Cancer
Donna Harris, 52 of Pikeville, was diagnosed with stage 3 colorectal cancer in early December of 2018. It would take some time for her to learn how to live with it She had been noticing for months that she was having an upset stomach, nausea and extreme fatigue. She visited her long-time physician, PMC Primary
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First Name:
Middle Name:
Last Name:
Are you 16 or older?	Yes No
Date of Birth:
Home #:
Cell #:
Email Address:
Present Address:
SSN:
Timeframe of shadowing request:
Emergency Contact:
Name:
Phone #:
I represent and warrant that I am not now nor have I ever been (i) listed by an agency or entity as excluded, debarred, suspended, or otherwise ineligible to participate in any federal, state, or private health care benefit program; (ii) listed as an excluded party by the U.S. Department of Health and Human Services or General Services Administration; (ii) been charged with, convicted of, pled guilty to, or entered a plea of non contendere (or any similar plea) with respect to any healthcare related offense; or (iv) been sanctioned for any form of healthcare fraud or abuse. I will notify Pikeville Medical Center immediately upon the commencement of any proceeding against me in which the outcome may be any of the above-described events. I further agree to execute any documentation necessary to comply with PMC’s vaccination policy, including any authorizations to release my protected health information or otherwise apply for an appropriate exemption. I agree that before I can be accepted as a physician shadow I must comply with PMC’s vaccination policy and failure to comply may lead to me not being accepted as a physician shadow or being dismissed as a physician shadow. I hereby attest that all of the foregoing information is true and correct. I authorize Pikeville Medical Center to obtain such background and personal reports as are deemed necessary to verify that the information I have supplied is true and accurate. A copy of this authorization is valid as the original.
Participant Signature:
Date:
If younger than 18 years of age, please have a Parent/Legal Guardian read and sign the following: I hereby attest that I am the Parent/Legal Guardian of the Applicant and that all of the foregoing information is true and correct. I authorize Pikeville Medical Center to obtain such background and personal reports regarding the Applicant as are deemed necessary to verify that the information I have supplied is true and accurate. A copy of this authorization is valid as the original.
Parent/Legal Guardian Signature:
Date:

Latest News and Events

3D Mammograms Increases Chance for Early Detection

Physicians Take Cancer Care to the Next Level

PMC Offering Clinical Trials for Cancer Patients

Outreach Programs Help Patient Learn to Live with Cancer

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